How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $144.54 | Facility | None | $114.82 | $114.82 | $144.54 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $125.89 Typical High $169.82 | Professional | None | $95.50 | $125.89 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $100.00 Typical High $269.15 | Facility | None | $83.18 | $100.00 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $223.87 Median $288.40 Typical High $354.81 | Professional | None | $223.87 | $288.40 | $354.81 |
Medica Setting Facility Modifier None Typical Low $125.89 Median $158.49 Typical High $257.04 | Facility | None | $125.89 | $158.49 | $257.04 |
Medica Setting Professional Modifier None Typical Low $144.54 Median $363.08 Typical High $1,096.48 | Professional | None | $144.54 | $363.08 | $1,096.48 |
Midlands Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $338.84 | Professional | None | $263.03 | $263.03 | $338.84 |
Midlands Setting Facility Modifier None Typical Low $83.18 Median $100.00 Typical High $114.82 | Facility | None | $83.18 | $100.00 | $114.82 |
Midlands Setting Professional Modifier None Typical Low $234.42 Median $251.19 Typical High $323.59 | Professional | None | $234.42 | $251.19 | $323.59 |
Sanford Health Plan Setting Professional Modifier None Typical Low $144.54 Median $213.80 Typical High $275.42 | Professional | None | $144.54 | $213.80 | $275.42 |
United Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $223.87 | Facility | None | $125.89 | $125.89 | $223.87 |
United Setting Professional Modifier None Typical Low $125.89 Median $288.40 Typical High $398.11 | Professional | None | $125.89 | $288.40 | $398.11 |
Wellmark Setting Professional Modifier None Typical Low $218.78 Median $257.04 Typical High $371.54 | Professional | None | $218.78 | $257.04 | $371.54 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $46.77 Median $63.10 Typical High $74.13 | Professional | 52 · Reduced service | $46.77 | $63.10 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $25.12 Typical High $29.51 | Professional | 53 · Discontinued | $19.05 | $25.12 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $18.62 Typical High $22.39 | Professional | 55 · Aftercare only | $14.13 | $18.62 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $12.59 Typical High $14.79 | Professional | 56 · Pre-op care only | $9.55 | $12.59 | $14.79 |
Where South Dakota sits
The same service costs 4.3 times more in Alaska than in Kentucky. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
South Dakota· 5th of 51
$257
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.